Pediatric obesity is one of the most important health issues facing the world today. Changing lifestyles, affluence on the rise, introduction to new diets, changing social order and an increasingly sedentary lifestyle of the youth have contributed to the alarming rise of child and adolescent obesity. Recent definitions of obesity by WHO and IOTF have afforded distinct cutoffs to determine prevalence of obesity at the community level in children. Newer insights into leptin and its signaling pathways have helped our understanding of the genesis of obesity, which has been further bolstered by the numerous studies into the genetics of obesity. Endocrine disorders like hypothyroidism, Cushing's syndrome, and syndromic disorders need to be ruled out. In addition to the routine investigations, evaluation of markers of insulin resistance and fat percentage is of great research utility In Indian children, who differ metabolically from children in the west. The cornerstones of treatment are therapeutic lifestyle changes, behavior modification and pharmacological therapy when needed. However, primordial prevention by inculcation of a healthy lifestyle seems to be the best bet in combating pediatric obesity.